A real-world study of ixekizumab use patterns, switching and efficacy in patients with plaque psoriasis

The objective of this study was to evaluate the real-world use of ixekizumab, switching to other biologics, and associated efficacy. This two-year, single-center, retrospective, real-world study collected patient histories and medication records and assessed overall and difficult-to-treat efficacy. Of 258 patients, 31 patients (12%) extended the dosing interval to a mean of 2.6 ± 1.3 months after a mean of 6.6 ± 3.6 months of treatment, with similar efficacy to patients using the labeled dosing interval. In 98 patients who crossed over from secukinumab to ixekizumab, the Psoriasis Area and Severity Index (PASI) 75/90/100 response at 3 months was 78.8%, 61.2% and 41.2%, respectively. The PASI 75/90/100 response at 3 months in patients who switched from ixekizumab to secukinumab (27 patients) was 62.5%, 41.7%, and 33.3%, respectively, while the PASI 75/90/100 response in patients who switched from ixekizumab to adalimumab (12 patients) was 54.5%, 36.4%, and 0%, respectively. Switching from secukinumab to ixekizumab, from ixekizumab to secukinumab, and from ixekizumab to adalimumab in difficult-to-treat areas such as the scalp, genitals, and nails resulted in good responses. Ixekizumab can extend the dosing interval in patients who respond well. Switching biologic therapy between ixekizumab and secukinumab and adalimumab may be considered, as this switching strategy is also used in difficult-to-treat areas.